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Sp 15-Micro Final > Hypersensitivity > Flashcards

Hypersensitivity Flashcards

1
Q

What is hypersensitivity?

A

Exaggerated or abnormal immune response to an antigen resulting in inflammation and tissue damage

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2
Q

Which Type of hypersensitivity is most common?

A

Type 1

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3
Q

What is the immune reactant of Type I hypersensitivity?

A

IgE

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4
Q

What are common syndromes associated with Type1?

A 
Systemic Anaphylaxis
Acute Urticaria (wheel-and-flare)
Allergic rhinitis
asthma
food allergy
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5
Q

What is the antigen for Type1 disorders?

A

Soluble antigen

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6
Q

The most serious Type 1 disorder is _________ and the route of entry for the antigen is ______ or _____.

A

Systemic Anaphylaxis
intravenous
oral

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7
Q

Edema, increased vascular permeability, tracheal occlusion are all responses due to ______.

A

Systemic anaphylaxis

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8
Q

With Wheel-and-flare disorders the antigen is acquired through ______; whereas antigens associated with hay fever and asthma are acquired through______.

A

the skin

inhalation

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9
Q

Type 1 hypersensitivity is referred to as immediate because it occurs within minutes after ________ to antigen/allergen.

A

REexposure

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10
Q

Which type of hypersensitivity is associated with “mast cell mediated vascular and smooth muscle reaction and inflammation?”

A

Type 1

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11
Q

Which type of hypersensitivity is associated with “mast cell mediated vascular and smooth muscle reaction and inflammation?”

A

Type 1

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12
Q

What is sensitization?

A

Initial exposure to antigen and production of IgE antibodies

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13
Q

IgE antibodies are bound by ___ receptors on _____ cells.

A

Fc receptors

Mast cells

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14
Q

What are the two stages of the biphasic response in Type 1 Hypersensitivity?

A
  1. Immediate Effects (dilation of vessels, inc permeability)

2. Late Response (inflammation)

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15
Q

What are the two stages of the biphasic response in Type 1 Hypersensitivity?

A
  1. Immediate Effects (dilation of vessels, inc permeability)

2. Late Response (inflammation)

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16
Q

Initial exposure to antigen results in the activation of Th2 cells and the release of ____ cytokines. These cytokines will then trigger the production of IgE associated with Type 1 hypersensitivity.

A

IL-4, IL-5, and IL-13

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17
Q

In Type 1 hypersensitivity, a secondary exposure to a particular antigen will result in activation of _______ cells.

A

Mast

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18
Q

Mast cell degranulation results in the increase of vasoactive amines, such as ______ and ______, as well as proteases.

A

Histamine

Serotonin

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19
Q

What are two important lipid mediators that are synthesized and secreted by mast cells?

A

Prostaglandins (vasoconstriction of lungs)

Leukotrienes (bronchocontriction, inc. vascular permiab.)

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20
Q

Prostaglandins and leukotrienes are derived from ______ acid.

A

Arachidonic

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21
Q

Leukotrienes are referred to as slow-reacting substance of anaphylaxis (SRS-A) and act to _______ vascular permeability and constrict the bronchi.

A

increase

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22
Q

What does IL-5 recruit?

A

Eosinophils

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23
Q

In the late phase response of Type1 Hypersensitivity, there is a synthesis and secretion of important _____.

A

Cytokines and Chemokines

*IL-4, IL-5, TNF-alpha

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24
Q

Eosinophils release granules that contain _____ that will damage indiscriminately.

A

ROS

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25
Q

Eosinophils release granules that contain _____ that will damage indiscriminately.

A

ROS

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26
Q

Initiation of mast cell degranulation involves ______.

A

ITAMs

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27
Q

What are the cellular events of mast cell activation?

  1. Bind ______
  2. Trigger _______
  3. Activate _______ and _______
  4. ______ will lead to expression of cytokines
  5. ______ will lead to the release of granules
A
  1. allergen at cell surface
  2. ITAMs
  3. PKC, MAP Kinase
  4. MAP Kinase
  5. PKC
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28
Q

What are two functions of MAP kinase in mast cell activation?

A
  1. “Cytokine expression”

2. Initiate PLA2 that will create arachidonic acid and eventually “Lipid Mediators”

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29
Q

During mast cell activation, ______ is involved in the creation of lipid mediators and cytokines; whereas, ______ is involved in the release of granules.

A

MAP Kinase

PKC

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30
Q

Asthmatics tend to produce _____ and form thicker _____ that restrict the airway.

A

Extra mucous

tracheal walls

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31
Q

______ are a common trigger of asthma.

A

Dust mites

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32
Q

What enzyme do dust mites produce that cleaves tight junctions and allows mites to enter/trigger mast cell degranulation?

A

Der p 1 (derp)

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33
Q

Two common long-term control medications for asthma are 1._______ and 2._______.

A
  1. Inhaled Corticosteroids

2. Leukotriene Modifiers

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34
Q

The _____ and ____ __ _____ of allergens will determine the type of IgE-mediated allergic reaction that results.

A

Dose

Route of entry

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35
Q

The “wheel-and-flare” reaction in the skin is in response to ______ cell mediators and local blood vessel dilation.

A

mast

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36
Q

Inflammation results from mast cell release of _______ and _______.

A

Cytokines

Lipid Mediators

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37
Q

Bronchoconstriction, intestinal hypermotility, and vasular leakage result from mast cell release of _____ and ________.

A

Biogenic amines

Lipid Mediators

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38
Q

What are the three important steps in Type 1 Hypersensitivity?

A
  1. Mast Cell degranulation
  2. Synthesis and secretion of lipid mediators
  3. Cytokine release
39
Q

What are the three important steps in Type 1 Hypersensitivity?

A
  1. Mast Cell degranulation
  2. Synthesis and secretion of lipid mediators
  3. Cytokine release
40
Q

Type II Hypersensitivity involves _____ antibody binding to antigens on self cell surfaces.

A

IgG

41
Q

Type I involves soluble antigen; whereas, Type II involves _____ antigen or ______ receptor.

A

cell-associated antigen

cell-surface receptor

42
Q

Autoimmune hemolytic anemia, myasthenia gravis, and Graves disease are associated with Type _______.

A

Type II Hypersensitivity

43
Q

Type II can activate _______ and result in membrane attack complex formation that leads to destruction of cells, inflammation, or interference with normal cell function.

A

Complement

44
Q

Hemolytic disease of newborns is a Type ___ disorder in which maternal ____ target fetal ______ for destruction.

A

II
Antibodies
RBCs

45
Q

______ Disease is a type II hypersensitivity associated with overproduction of thyroid hormone.

A

Graves

46
Q

What is the Type II disease associated with muscle weakness from blockage of the Ach receptor?

A

Myasthenia Gravis

47
Q

Autoimmune hemolytic anemia is commonly treated with _____ (i.e. Prednisone) or _______.

A

Corticosteroids

Blood Transfusion

48
Q

In Type II hypersensitivity, host _____ binds to foreign ____ on cell surfaces or binds to ____.

A

antibody
antigen
self-antigen

49
Q

In Type II hypersensitivity, host _____ binds to foreign ____ on cell surfaces or binds to ____.

A

antibody
antigen
self-antigen

50
Q

Which type of hypersensitivity is associated with Ag-Ab complexes that clump and deposit in blood vessels or tissues and then attract acute inflammatory reaction?

A

Type III

immune complex mediated

51
Q

______ aggregates fix complement and are cleared from circulation, but ____ complexes formed in Ag excess will deposit in vessels or tissue.

A 
Large = cleared
Small = deposit
52
Q

Small deposited complexes will ligate _____ receptors on leukocytes and lead to tissue damage.

A

Fc

53
Q

Immune deposits in Type III HS will generally accumulate at sites where antigen is localized or at sites of ______ or high ______.

A

Turbulence (blood flow)

Pressure (kidneys)

54
Q

Immune complexes associated with Type III HS will trigger inflammation via what three mechanisms?

A
  1. Mast cell activation
  2. Macrophage release of TNF-alpha and IL-1 (create Reactive Epithelium)
  3. Complement activation (release more histamine and serotonin)
55
Q

Which cytokines will induce a “reactive epithelium” and from which cell are they released?

A

TNF-alpha, IL-1

Released from MACROPHAGEs

56
Q

The complement cascade in Type III HS will stimulate mast cells to release more ______, _______, and chemotactic factors.

A

histamine

serotonin

57
Q

Cells bearing Fc receptors for _____ are crucial for antibody-complex-mediated hypersensitivity.

A

IgG

58
Q

Cells bearing Fc receptors for _____ are crucial for antibody-complex-mediated hypersensitivity.

A

IgG

59
Q

What is the arthus reaction?

A

a type III HS reaction in the skin that is triggered by IgG

60
Q

What is the arthus reaction?

A

a type III HS reaction in the skin that is triggered by IgG

61
Q

Which complement molecule will activate leukocytes?

A

C5a

62
Q

Which cytokines induce the formation of reactive epithelium?

A

TNF-alpha

IL-1

63
Q

_____ reaction typically occurs in vessel walls, pleura, pericardium, synovium, or glomeruli and can result from repeated subcutaneous injections.

A

Arthus

64
Q

Serum sickness is a classic example of transient ________ immune complex-mediated syndrome that will usually resolve itself with Ab response.

A

Systemic

65
Q

Which (life-threatening) Type III HS disorder involves IgG antibody directed against DNA in skin, joints, and kidneys?

A

SLE

66
Q

Arthus reaction, Serum Sickness, and SLE are examples of ________ Hypersensitivity. This Type is also known as?

A

Type III

Immune-Complex Mediated

67
Q

Arthus reaction, Serum Sickness, and SLE are examples of ________ Hypersensitivity. This Type is also known as?

A

Type III

Immune-Complex Mediated

68
Q

Which type of hypersensitivity involves T cells?

A

Type IV

69
Q

In Type IV HS, ______ infiltration is induced by Ag specific ____ cells in a SENSITIZED individual.

A

Macrophage

T

70
Q

What is DTH?

A

Delayed Type Hypersensitivity

Type IV HS

71
Q

Contact dermatitis is an example of _____ hypersensitivity.

A

Type IV

72
Q

Macrophages, _______ T Cells, and NK cells are important effector cells in the DTH response.

A

CD8+

DTH = Type IV

73
Q

What are haptens?

A

Small molecules that must become bound to a larger carrier molecule in order to illicit an immune or inflammatory response (Generally responsible for initiating Type IV hypersensitivity)

74
Q

Type IV hypersensitivity: Antigen presented by APCs will activate _____ cells that will then secrete _____ and activate macrophages.

A

T helper

Cytokines

75
Q

The tuberculin test for TB involves a _______ inflammatory reaction that is mediated by _____ cells.

A

T cell-mediated

Th1

76
Q

The tuberculin test for TB involves a _______ inflammatory reaction that is mediated by _____ cells.

A

T cell-mediated

Th1

77
Q

Haptens (highly reactive small molecules) are complexed with skin proteins and are internalized by APCs which will lead to inflammation associated with ______ (ex. poison ivy).

A

Contact Dermatitis

78
Q

Contact dermatitis can be elicited by either ____ or ____.

A

CD4 T Cells

CD8 T Cells

79
Q

What are the two phases of contact hypersensitivity?

A
  1. sensitization

2. Elicitation

80
Q

When does sensitization occur? How long does it take? What type of T cells are formed as a result?

A

During first exposure to antigen
Takes 10-14 days
CD4+ Memory T Cells

81
Q

When does elicitation occur? How long does it take? What will keratinocytes in the activated membrane release?

A

upon RE-EXPOSURE to a particular antigen
24-48 hours after presentation to memory cells
TNF-alpha and proinflammatory cytokines (IL-1)

82
Q

True or False: Contact Dermatitis is a Type III Hypersensitivity disorder that can be caused by allergens such as latex, solvents, medications, and fabrics.

A

False: contact dermatitis IS associated with these allergens but CD is a Type IV hypersensitivity disorder

83
Q

True or False: Contact Dermatitis is a Type III Hypersensitivity disorder that can be caused by allergens such as latex, solvents, medications, and fabrics.

A

False: contact dermatitis IS associated with these allergens but CD is a Type IV hypersensitivity disorder

84
Q

Mast cell degranulation that is associated with Chronic Asthma will lead to _____ and ______ influx.

A

Th2

Eosinophil

85
Q

Which cytokine is closely associated with eosinophils?

A

IL-5

86
Q

Inflammatory Bowel Disease (Crohn’s) is thought to be due to unresolved ______.

A

Delayed Type Hypersensitivity (DTH): Type IV

87
Q

Types ____ and _____ involve IgG.

A

II

III

88
Q

Type _____ involves IgE.

A

I

89
Q

Soluble antigen is associated with Types ____, _____, and _____.

A

I
III
IV
(not II)

90
Q

Match the Effector with the Type of HS:

  1. Complement
  2. Macrophage activation, Eosinophils
  3. Mast Cells
  4. Complement FcR cells, Antibody
A
  1. Type III
  2. Type IV
  3. Type I
  4. Type II
91
Q

Vasculitis, Nephritis, and Arthritis are associated with which hypersensitivity type?

A

Type III

92
Q

In Type IV Hypersensitivity, Th1 cells will activate ______; whereas, Th2 cells will activate ________.

A

Macrophages

Eosinophils

93
Q

What is the mneumonic for remembering the different hypersensitivity types?

A

ACID
Type 1: Allergic (anaphylaxis)
Type 2: Cytotoxic (drug allergies,
Type 3: Immune Complex (deposits in tissue/vessels)
Type 4: Delayed (contact dermatitis, TB testing)

Sp 15-Micro Final (12 decks)

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